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That rates of primary and repeat cesarean deliveries are rising is well known, but underlying trends in indications for this delivery mode are less clear. Investigators evaluated medical records, labor logs, and administrator-recorded count data to analyze rates of specific indications for cesarean birth at a major U.S. academic medical center from 2003 through 2009. The study period encompassed 32,443 live births, 10,757 of which were by cesarean delivery (33.3%).
Cesarean delivery rates increased from 26.0% in 2003 to 36.5% in 2009. Both primary and repeat cesarean rates rose, whereas rates of vaginal birth after cesarean fell (from 17.8% to 7.8%). Half of the total rise in cesarean births was attributable to primary cesarean deliveries. A…